AN EQUAL OPPORTUNITY EMPLOYER APPLICATION FOR EMPLOYMENT (PLEASE PRINT IN INK. YOU MUST COMPLETE ENTIRE QUESTIONNAIRE) PERSONAL INFORMATION: Today s Date: Name Last First Middle Home Address Street City State Zip Home Phone Number Are you 18 years or older? YES NO Are you either a U.S. citizen or an alien authorized to work in the United States? YES NO EMPLOYMENT DESIRED: Position Date You Can Start Salary Desired Are you employed now? YES NO If so, may we inquire of your present employer? YES NO Ever applied to this company before? YES NO If Yes, When? Referred by: Agency Walk-in Friend/Relative Newspaper School Other Have you ever worked for ERIE PRESS SYSTEMS before? YES NO If yes, date of employment Position while employed: EDUCATION Grammar School School Name & Location Number of Year Attended Did You Graduate? Subjects Studied High School College Trade, Business or Correspondence
GENERAL: Subjects of special study or research work: Special Skills: Activities (Civic, Athletic, etc.): Exclude organizations, the name of which indicates race, religion, disability, sex, age, marital status, color or national origin. U.S. Military or Naval Service: Rank: FORMER EMPLOYERS: Date Month & Year Name & Address of Employer Salary Position Reason for Leaving Have you ever been convicted of a felony or misdemeanor, excluding traffic offenses? Yes No (If yes, please explain.) (A conviction record will not necessarily be a bar to employment and factors such as age and time of offense, seriousness and nature of the violation and rehabilitation will be taken into account.)
SKILLS LIST: (Please check all that apply to you) WELDING CERTIFICATIONS Basic Welding Pipe Welding Maintenance Welding SKILLS Pipefitting Electrical Mechanical Assembly ABILITY TO READ Mechanical Drawings Hydraulic Schematics Electrical Schematics ABILITY TO OPERATE Horizontal Boring Machine Metal Saw Band Saw Planer Mill Jib Crane Overhead Crane Fork Lift Drill Press Blanchard Grinder CNC Controlled Machine Vertical Boring Machine Air Tools Lathes Scissor/Aerial Lifts ABILITY TO Recognize and Confirm Various Mechanical Functions of a Machine Use Various Hand Tools Use Precision Measuring Instruments MAINTENANCE SKILLS General Maintenance Control/Service Skills Mechanical Machine Maintenance Repair Electrical Machine Maintenance Repair TECHNICAL KNOWLDEGE OF Machine Controls Surface Finishes Fits & Tolerances Various Forging Processes Mechanical Systems ISO 9000 Series Standards Quality Systems Process Skills Design & Process FMEA skills Hydraulic or Mechanical Press Evaluation Skills Reliability & Maintainability Guidelines
TECHNICAL SKILLS CNC Programming Machining Skills Work Planning Skills MRP Knowledgeable Shop Math Algebra Analytical Geometry Trigonometry Calculus AutoCAD Knowledge of Logistics Knowledge of Rigging Design Analysis & Development Knowledge of PLC Based Systems Technical writing skills Knowledge of PC Based Systems COMPUTER & PERSONAL SKILLS Computer Literate Communication Skills Customer Relation Skills Negotiation Skills Microsoft Word Microsoft PowerPoint Microsoft Access Microsoft Excel Keyboarding Skills Modern Office Practices Problem Solving Skills Estimating skills Training Skills Trouble-Shooting Skills Interpersonal Skills Interviewing Skills Selling Skills Leadership Skills Ability to Operate a Multi-line Switchboard Contractual or Legal Language Skills Knowledge of Government regulations (FAR s, etc.) Ability to Use and Care for General Office Equipment Knowledge of Statistical Techniques ASQ Certification
REFERENCES: Give the names of three persons not related to you whom you have known at least one year. Name Address & Phone Number Business Years Acquainted In case of emergency notify: Name Address Phone Please Read Carefully Before Signing This Form 1. All information contained in this application is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind in this application or in any other manner may result in denial of employment or be cause for subsequent dismissal if I am hired. 2. I authorize the Company to investigate my responses on this application, and contact any or all of my former employers or any individuals familiar with me or my employment background for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information, whether favorable or unfavorable, about my employment or me. I voluntary and knowingly fully release and hold harmless any person or organization that provides information pertaining to my employment or me. 3. I understand that upon receiving a job offer, a physical examination and drug screening are required as a condition of my employment. 4. In consideration of my employment, I agree to conform to the policies and procedures of the Company. I understand that in accepting this application, the Company is in no way obligated to provide me with employment, and I am not obligated to accept employment if offered. Regardless of whether or not I become employed by the Company, I recognize that this application is not and should not be considered a contract of employment. I understand that employment at the Company is on an at-will basis. My employment may, regardless of the date of payment of my wages and salary, be terminated with or without cause, and with or without notice, at any time, unless specifically provided otherwise in a written employment contract. I further understand that no Company employee or representative has the authority to enter into a contract regarding duration or terms and conditions of employment other than an officer or official of the Company, and, then, only by means of a signed, written document. Date Signature of Applicant By clicking on this check box I authorize that all of the above information is correct and that this check box will represent my signature of authorization.